NPIMap

Organization Active NPI

Sparks Regional Medical Center

  • Foot & Ankle Surgery Podiatrist
  • Fort Smith, AR
National Provider Identifier
1679784367
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
239 Issued in AR
Legal business name
SPARKS REGIONAL MEDICAL CENTER
Practice address
1500 Dodson Ave
Ste 290
Fort Smith, AR 72901-5182
Phone
(479) 709-7399
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rebecca Friddle
Title
Sparks Provider Relations Manager
Phone
(479) 709-7057

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 239 AR Primary
Durable Medical Equipment & Medical Supplies 332B00000X AR

Addresses

Primary practice location

1500 Dodson Ave
Ste 290
Fort Smith, AR 72901-5182

Mailing address

PO Box 1824
Fort Smith, AR 72902-1824
Phone (479) 709-7399

Other identifiers 1

IdentifierTypeStateIssuer
200116230AMedicaidOK

Other names 1

  • SMF Foot & Ankle Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sparks Regional Medical Center30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

1500 Dodson Ave
Ste 290
Fort Smith, AR 72901
Phone (479) 573-7905

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1679784367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729021824",
            "telephone_number": "479-709-7399",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DODSON AVE",
            "address_2": "STE 290",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015182",
            "telephone_number": "479-709-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "FRIDDLE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "SPARKS PROVIDER RELATIONS MANAGER",
        "authorized_official_telephone_number": "479-709-7057"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AR",
            "license": "239",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200116230A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMF Foot & Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.